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September 27, 2012

While You Were Sleeping

Blockbuster sleep drug Ambien has been hailed as a lifesaver, by women especially, who depend on it to conquer insomnia and jet lag. But its bizarre, sometimes tragic side effects raise alarming questions about the go-to-bedtime fix.

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Left: Lindsey Schweigert's mug shot.

Following her arrest, Lindsey Schweigert faced a conviction that would most certainly compromise her security clearance and likely cost her her job. Forever after, she'd be forced to disclose her arrest record on job applications and a slew of other documents. Not to mention the hassle of losing her license, increased car insurance premiums, and the humiliating conversations with friends and family (to say nothing of prospective boyfriends) about her arrest. Schweigert had good reason to worry that a conviction might damage her life.

Her lawyer, Jacquelyn Hunt, invoked a novel legal strategy, one that defendants in Ambien-induced predicaments have begun asserting in DWI cases across the country. Citing the FDA-mandated label, Hunt argued that what happened to Schweigert was a known side effect of Ambien — and not a crime. Cops should have taken her to the hospital, not jail, Hunt reasoned. Defendants asserting this so-called Ambien defense have had mixed results. In a seminal case, the attorney for 51-year-old Marie Connelly of Hillsborough, New Jersey, used it to overturn his client's 2006 DWI conviction, noting the FDA label change six months after her arrest. The appellate court ruled it would be an "injustice to hold her responsible for the undisclosed side effects of a popular and readily available medication that she was lawfully prescribed and properly administered."

Still, many judges and prosecutors find the notion of sleep-driving inherently implausible despite FDA recognition that it can — and does — happen. The legal dockets are filled with cases like the arrest of Kristine Story, 32, of Fairbanks, Alaska, who was busted in April 2008 after taking an Ambien and "waking up" in a patrol car. After callers reported her as a drunk driver, cops following her home were surprised to find she'd left two young children unsupervised. While she was acquitted of child endangerment charges, the judge in Story's case refused to consider her sleep-driving defense, and she was ultimately convicted of driving under the influence.

Herein lies the legal rub: If you injure, or even kill, someone while under the influence of Ambien, you may have a better shot of getting off than if you, say, crash into a tree. That's because DWI, in most states, is a strict liability offense — prosecutors don't have to prove you intended to get behind the wheel while impaired, only that you did, a case easily made with a police report and drug test. But defendants who face more serious criminal charges — some involving vehicular homicide — have fared better with the Ambien defense since it's the prosecutor's burden to prove the defendant had a culpable state of mind. That's hard to do if the defendant, after taking Ambien, isn't entirely conscious. So drivers who've actually caused fatal accidents while on Ambien have been exonerated, while those facing routine DWI charges, like Schweigert, have not. Case in point: In June 2006, Ki Yong O, a 36-year-old lawyer from Andover, Massachusetts, was sleep-driving on Ambien when he struck and killed Anthony Raucci, who was changing a tire alongside his wife and young son. Two years later, Donna Neely, 56, also sleep-driving while on Ambien, killed Cho Thao Her, a mother of 11 children. Both were acquitted of vehicular manslaughter.

Some Ambien users have sought to evade criminal charges by blaming their sleep-driving episodes on purported seizures. This summer, Kerry Kennedy, daughter of Robert Kennedy and ex-wife of New York Governor Andrew Cuomo, suggested seizures caused her to swerve into a tractor trailer at 8 a.m. in Westchester, New York, and drive away. But toxicology reports confirmed that she had Ambien in her system, lending credence to speculation that she was sleep-driving. Later, Kennedy issued a statement saying she may have confused her thyroid medication with Ambien. (Charges against her are pending.)

In Schweigert's case, prosecutors initially sought a six-month jail sentence and a host of other penalties. But after hearing her Ambien story, they let her plead guilty to careless driving, a lesser charge that at least preserved her security clearance. Still, the consequences were harsh. Her license was suspended for more than a year, and putting the ordeal behind her cost upwards of $9,000 in legal fees.

Here's a scene familiar to many Ambien users: You're jet-lagged from an overseas trip but have a crucial early-morning presentation. What you need more than anything else is a good night's sleep. So after dinner and a glass or two of Chardonnay to calm your nerves, you retrieve that Ambien prescription from your carry-on, a godsend courtesy of a sympathetic internist. You take a quick shower, pop a pill, slide into bed, and drift off to sleep.

"The combination of alcohol and Ambien is incredibly dangerous," warns toxicologist Janci Lindsay, Ph.D. Alcohol amplifies Ambien's hypnotic effect and triggers arousal, making it much more likely that you'll get out of bed while in a trancelike state to satisfy whatever urge is nipping at your brain. Though the Ambien label cautions against taking the drug with alcohol, it is an alarmingly common practice. Some 60 percent of people taking medications known to interact with alcohol still drink, according to a 2008 joint study by researchers at Brown University and the University of Rhode Island. After all, it's easy to get complacent with a drug you've taken for months, even years, as is frequently the case with Ambien.

In May 2012, San Antonio, Texas, residents closely followed the trial of Julie Ann Bronson, a 42-year-old flight attendant who ran over a mother and her two daughters while sleep-driving, severely crippling the youngest daughter. Bronson, a Delta Flight Attendant of the Year for three years running, admitted to having five glasses of wine on the afternoon of April 23, 2009, after returning home from an international flight. Bronson was disappointed that her husband, a Delta pilot, couldn't catch a flight home that night and took an Ambien before going to bed. The next thing she remembers is waking up in a holding cell, barefoot and in pajamas. "A lady told me I'd assaulted a woman and a child," Bronson testified. "I'd never hit anyone in my life. It was surreal. It was like a bad dream."

According to the police report, Bronson got into her Mercedes convertible and drove through her gated neighborhood where Traci Lopez, a nurse, was picking up grass clippings with her daughters. Security video shows Bronson driving erratically, then swerving onto the curb, striking all three and flipping 18-month-old Ava into the air. She continued to drive despite blowing out two tires. Police later pulled her over and charged her with intoxication, assault, and failure to stop and render aid.

Bronson pleaded guilty to the felony charges, admitting that she should not have taken Ambien after drinking. She faced 10 years in prison, but a jury, following a weeklong trial, was convinced that she didn't intentionally drive and sentenced her to probation instead. Her life, says Bronson's attorney, Patrick Hancock, was ruined by taking Ambien: "She was an 18-year veteran flight attendant for a major airline and she lost her career." Worse, "knowing she devastated a family and injured a child is something that she wanted to take her own life for."

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